Guest Columns

E-cigarettes: A boon or bane?

E-cigarettes as noted by WHO in its recent report represents an “evolving frontier filled with promise and threat for tobacco control’ which would require regulations. It is now a booming industry with 466 brands and 7764 unique flavours as of early 2014. These are easily available over internet. A simple google search will reveal various online stores, including in namma Bengaluru. They are also available in retail stores in several countries. As per some estimates e-cigarettes sales will grow by $10 billion and surpass that of conventional cigarettes by 2017.

E-cigarettes not to be confused with Nicotine Replacement Therapy (NRT). Time to displace nicotine rather than replace it:

E-cigarettes is one of the prototype of Electronic Nicotine Delivery system (ENDS) and is not a recognized/ licensed as NRT. In contrast to e-cigarettes, usual NRT implies delivery of only nicotine minus the other hazardous chemicals in tobacco products and it is a monitored system, generally under professional help, requiring gradual tapering in nicotine dosage to help in quitting tobacco.

Why e-cigarettes are not a harm reduction device?

E-cigarettes may seem similar to NRT in the respect that it also delivers only nicotine eliminating other dangerous chemicals. But since they are not strictly regulated we can’t be sure of what all chemicals are going into those vapors. There is not much research on the composition of these e-liquids and the potential harms they have on bystanders. The efficacy to help in quitting also needs to be proven beyond doubt before they are promoted and made freely available. More importantly, cigarette (or tobacco) addiction has a strong psychosocial component making it equally important to break away from habit and connotations of smoking behavior. E-cigarettes does not help in that as it is still a cigarette like devise hand held and smoked like cigarette.

Some vested interests? As the same industry produces it.

The three of the big tobacco companies have been purchasing e-cigarettes companies and might own 75% of the profit pool within the next decade. Doesn’t that raise a question on the credibility of the product and the intention of manufacturers? How can one trust the same industry which takes six million lives a year, and for which selling death in form of tobacco is a bottom-line, to now produce a less harmful product. Contrary to it, a recent report revealed that over decades, big tobacco companies have invested in making cigarettes more deadlier and addictive.

A gateway to nicotine and other tobacco products?

E-cigarettes as one of the advertisements markets – looks like cigarettes, tastes like cigarettes but is not ‘cigarette’. Hence it can easily act as a starter product for young children and adolescents. In fact a recent study by US Centres for Disease Control (CDC) shows the experimentation of e-cigarettes by middle and high school students has doubled in between 2011-2012.

A way to get around existing laws.

E-cigarettes also happen to get around existing laws in several countries regulating tobacco use. The advertising, sale, use in public places etc. has not been regulated under the existing tobacco control laws. WHO report also calls for stronger regulation until the benefits for quitting are proven beyond any reasonable doubt.

To summarize, nicotine is the route to addiction and industry is using this drug to help people not forget tobacco. If not for nicotine these cigarettes will be useless. Thus it is just another way of keeping nicotine in blood to maintain cigarette smoking habits among existing customers and new way to attract young customers using technology to lure young minds, while serving purpose to deliver nicotine. In addition, an innovative attempt to subvert the existing law which is gaining hold in the country. On this National Cancer Awareness, it is of importance to take note of such emerging threats and devise suitable policies in the interest of public health. E-cigarettes need to be regulated at par with conventional cigarettes to avoid easy access to youth from experimenting them and later getting addicted to tobacco products.


The writer is Dr Vishal Rao US, Director,Cancer Prevention Project at Institute of Public Health and Surgical Oncologist, BGS Global Hospital and Oncology Institute.


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